Methotrexate-related lymphoproliferative disorder of the lumbar spine origin presenting with severe low-back pain: case report

Journal of Neurosurgery. Spine
Naoya KikuchiMasashi Yamazaki

Abstract

The use of methotrexate (MTX) to treat rheumatoid arthritis (RA) is increasing. Recently, MTX-associated lymphoproliferative disorder (MTX-LPD) has been frequently reported as lymphoma occurring during MTX therapy. The authors report their experience with a relatively rare case of MTX-LPD presenting in the lumbar spine. The patient, a 73-year-old woman who experienced low-back pain while receiving MTX therapy for RA, was suspected of having developed MTX-LPD based on her medical history, images of the L1 vertebra, and transpedicular biopsy results. One week after discontinuing MTX, the patient's low-back pain reportedly improved. The woman was diagnosed with MTX-LPD based on histopathological findings. MTX discontinuation alone coincided with spontaneous tumor regression. Because MTX-LPD can occur in tissues other than lymph nodes, such as in bones and joints, it is a disease that should be considered when diagnosing spinal tumors in patients receiving MTX therapy.

References

Jun 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·E SalloumJ Murren
Jun 1, 1997·Seminars in Arthritis and Rheumatism·J M Kremer
May 16, 2002·Blood·Xavier MarietteUNKNOWN Investigators of the Club Rhumatismes et Inflammation

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